ABSRACT Objective To analyze the value of CEUS in differential diagnosis of liver epithelioid angiomyolipoma (EAML) and hepatocellular carcinoma. Methods The CEUS data of 40 patients with EAML and 40 patients with hepatocellular carcinoma were analyzed retrospectively. Qualitative and quantitative analysis of images was carried out with Qontrast software. The results of qualitative analysis included the degree of enhancement in different real-time enhancement periods. The results of quantitative analysis included the arrival time, peak intensity, peak time, enhancement slope and the start time of fading. Results Compared with the hepatocellular carcinoma group, the echo degree of EAML group was lower and the number of lesions was more (P＜0.05). There was no significant difference between the two groups in the intensity of blood flow signal, the location of focus and the edge of focus (P > 0.05). Compared with hepatocellular carcinoma group, there were more cases of centripetal enhancement in EAML group, and the degree of delayed phase enhancement was lower (P < 0.05). There was no significant difference between the two groups in the enhancement degree of arterial phase and portal phase (P > 0.05). Compared with the hepatocellular carcinoma group, the peak intensity of EAML group was higher, while the peak time and the beginning time of regression were shorter (P < 0.05). There was no significant difference in enhancement slope and arrival time between the two groups (P > 0.05). Conclusion There are different blood perfusion characteristics between EAML and hepatocellular carcinoma. CEUS is valuable for the differential diagnosis of these two diseases.